This medicine has an antispasmodic effect on the smooth muscles of various organs. Children's papaverine is produced separately - in the form of tablets. Also, children are allowed, according to indications, to give injections with medication and use candles. But this is not so convenient, because the “for adults” candle has to be divided into parts “by eye”. We will find out for what ailments papaverine is used for children, and how to do it correctly.

Papaverine, blocking the activity of certain enzymes, has a relaxing effect on the smooth muscles of the internal organs. With increased activity muscle fibers digestive, excretory organs, bronchi are greatly reduced, there are characteristic spasmodic pains of varying intensity.

The pharmaceutical remedy suppresses compression and pain sensations, helps to relax muscles and restore the functioning of organs.

Since the drug is not selective, it effectively counteracts spasms and pains of any organ, and is used very widely.

How else does the pharmaceutical work? It is able to lower blood pressure because it relaxes the muscles in the blood vessels. Also, in large doses, it reduces cardiac excitability and calms the central nervous system.

The agent in any form is rapidly absorbed into the blood and excreted through the kidneys. Half of the dose received is excreted over a period of thirty minutes to two hours.

When is the medicine used?

Carry out treatment with this pharmaceutical for such diseases and conditions:

• With inflammatory processes in the gallbladder, kidneys, esophagus and other organs of the abdominal cavity;
• With endarteritis and vascular diseases of the brain;
• At high temperatures (in combination with other agents);
• With heart ailments;
• With bronchospasm and severe cough.

In addition, a pharmaceutical agent is often used as an additional preparation for preparing patients for medical research and surgery.

Instructions for use and dosage

Papaverine for children under one year old is usually prescribed to relieve spasmodic abdominal pain and intestinal colic. Parents' reviews also speak of a beneficial effect on muscle work and metabolism in the smallest when using medication for electrophoresis.

Older children are recommended papaverine for other diseases. So, this medication or its analogue is recommended shortly before taking an antipyretic. Otherwise, if the limbs are cold, and the temperature is extremely high, it will not have the desired effect, since the constricted vessels will not give off excess heat and cool the body.

As prescribed by the doctor, the average course of the drug is one to two weeks. Feedback from applicants says that problems are solved faster.

Children's doses in tablets

Regardless of the age of the baby, the pharmaceutical is given twice a day. How to calculate the correct dosage when taking pills:

The tablets are swallowed whole with the required amount of water (about a glass). The drug is used regardless of food intake, as needed, that is, with pain, severe spasm. However, with frequent spasmodic pain in the abdominal cavity, it is worth taking it fifteen to thirty minutes before meals, so that the remedy stops spasmodic manifestations, and the child can safely eat.

Features of using the injection form and suppositories

In order to give children an injection of the drug, use the following dosages twice a day:

One ampoule contains 2 ml of a two percent solution of papaverine, the total amount of the active ingredient in it is similar to that of an adult tablet. Injections are given subcutaneously or intramuscularly; in a diluted form, intravenous injections are possible.

The dosage of papaverine in suppositories for various diseases, accompanied by contractions and spasmodic pains, depends on age. For babies under ten years old, rectal suppositories with papaverine should be divided into two or four parts.

How many such pieces are allowed? Crumbs up to four years old can only be administered a quarter of the suppository, and children 5-10 years old - half twice a day.

Parents' comments say that rectal suppositories with papaverine are also useful for constipation. The baby will not only experience pain relief, but also gently empty the bowel.

Many are interested in the question: is it possible for a child to be given adult pills, divided into pieces. Doctors do not recommend doing this. Toddlers need low-dose baby pills or suppositories. In severe cases, it is possible to use injections (under medical supervision).

Contraindications, side effects and overdose

Overdose is determined by weakness, bifurcation of the surrounding objects, drowsiness and decreased blood pressure. To eliminate it, they wash the stomach and give the baby enterosorbents, the same activated carbon. If the pressure drops sharply and strongly, urgently call an ambulance

Pharmaceutical drug is contraindicated:

• Children with excessive sensitivity to drug components;
• Glaucoma patients;
• Babies with severe liver failure;
• Children after head injuries.

Among the side effects are allergic reactions to substances contained in papaverine, a decrease in pressure, nausea, upset stools, nausea, and excessive sweating.

Compatibility with other pharmaceuticals and analogues

In combination with barbiturates, analgin, diphenhydramine and paracetamol, the antispasmodic effect of the drug increases.

An injection with analgin, papaverine and diphenhydramine is a universal remedy for an ambulance with fever and muscle pain.

At a child's temperature, 0.1 ml of the drug will be required for each crumbs year. So, the composition for a three-year-old toddler will include:

• Analgin - 0.3 ml;
• Papaverine - 0.3 ml;
• Diphenhydramine - 0.3 ml.

The combination "papaverine + diphenhydramine" is used quite often, as it relieves pain well and practically does not give side effects... So, diphenhydramine with papaverine is used for children who have undergone surgery.

According to doctors' reviews, it is also effective to combine analgin, papaverine and suprastin in injections at temperatures above 38 degrees and when it is impossible to give a pill to the crumbs, for example, with vomiting. This composition is also used for severe respiratory cramps. Each drug will also need 0.1 ml for each year of the baby's life. That is, for a four-year-old child, the mixture will contain analgin, suprastin and papaverine - 0.4 ml each.

It should be borne in mind that with the general use of papaverine with blood pressure lowering agents, antidepressants, the hypotensive effect increases. It is not recommended to combine it with furadonin, so as not to harm the liver.

Analogs are such pharmaceuticals as "", "Papazol", "Drotaverin", "Spazmol" and "Spazmonet".

When treating crumbs, even with baby pills, not to mention candles and injections, you need to correctly measure the doses and prevent the intake of an excess amount of pharmaceuticals. Before treatment, you must obtain permission from your pediatrician. Remember that only a doctor can make the correct diagnosis, do not self-medicate without consulting and making a diagnosis by a qualified doctor.

Injection:

• papaverine hydrochloride - 20 mg per 1 ml of medicinal liquid;
• D, L-methionine;
• disodium edetate;
• water for injections.

Pills:

• papaverine hydrochloride - 10 mg in 1 tablet;
• rafinated sugar;
• potato starch;
• stearic acid;
• talc.

Rectal suppositories:

• papaverine hydrochloride - 0.02 g in 1 candle weighing 1.25 g;
• emulsifier No. 1;
• cosmetic stearin;
• solid fat.

Release form

• Papaverine tablets 0.01 g or 0.04 g each, depending on the target audience of patients (the first are used in pediatric practice after 6 months), which are packaged in contour cell blisters of 10 pieces. The oral form has a slightly bitter taste, is white in color and is completely odorless.
• Solution for injection 2% in 2 ml ampoules. A cardboard package usually contains 10 pieces and instructions for use of a pharmaceutical preparation.
• Rectal suppositories or suppositories for introduction into the rectum, 0.02 g each; fixed in blisters of PVC or aluminum foil, 10 pieces. A plate with a medicine and an annotation are placed in a cardboard box.

pharmachologic effect

Papaverine hydrochloride (Wikipedia indicates that the INN of the drug corresponds to the name of the main active ingredient) - this is opium alkaloid acting on the smooth muscle elements and causing them to relax, therefore the pharmacological group of the drug is defined as myotropic antispasmodics .

The mechanism of the therapeutic action of a biological substance consists in influencing the secondary mediators (messengers) of the transmission of muscle excitement. Papaverine inhibits PDE (phosphodiesterase), due to which the cell accumulates cAMP (cycloadenosine monophosphate) and reduced ion content calcium , in response to such biochemical changes, the smooth muscles of the internal organs (digestive tube, respiratory and genitourinary systems and the vascular bed) relax, their tone decreases .

Pharmacopoeia is a set of mandatory rules and official regulations that guide the manufacture, testing, storage and prescribing of medicines to patients. Since the main biologically active component of a pharmaceutical preparation is potent, the pharmacopoeia for Papaverine hydrochloride includes the following points for determining the authenticity of a chemical:

• physical characteristics - a white crystalline powder, odorless, with a slightly bitter taste.
• Solubility - it dissolves in water for 40 hours, is slightly soluble in 95% alcohol, soluble in chloroform and practically insoluble in ether.
• Acidity 2% Papaverine hydrochloride solution - 3.0-4.5 (determined by potentiometric method).
• Chemical authentication control - 0.05 g of a pharmaceutical preparation is placed in a porcelain bowl, moistened with a couple of drops of high concentration nitric acid, after which a yellow coloration should appear, which, when heated in a water bath, changes to orange.
• The presence of organic impurities - test of dissolution and color change in 5 ml of concentrated sulfuric acid.

Pharmacodynamics and pharmacokinetics

The active ingredient is rapidly and almost completely absorbed by any route of administration of the drug into the body. Once in the bloodstream, it binds to plasma proteins (90% of the total biologically active substance), due to which it easily passes through the histohematological barriers. Biotransformation undergoes in the liver. The half-life is from 30 minutes to 2 hours, depending on the auxiliary components of the pharmaceutical preparation. It is excreted mainly by the kidneys in the form of metabolic products.

Indications for the use of Papaverine

• smooth muscle spasm organs of the abdominal cavity (especially often with , spastic or pylorospasm );
• hypertensive crisis (in combined conservative therapy);
• endarteritis ;
• spasm of the peripheral vascular bed;
• a decrease in the lumen of the vessels of the brain due to the contraction of the muscular layer of the arteries;
• bronchospasm ;
• reduction of arterial renal inflow of vascular origin;
• urinary retention due to urinary tract spasm.

Indications for use also include the stage premedication before surgical interventions in the abdominal cavity, proctological and urological manipulations. What is used for - relaxation of smooth muscle elements (for details, see the paragraph "Pharmacological action").

Contraindications

• intolerance of the constituent components of the drug;
• intracardiac conduction disorders, especially atrioventricular block ;
• hypersensitivity to a pharmaceutical product;
• heavy liver failure ;
• old age (since there is a significant risk of developing hyperthermic syndrome);
• children's age up to 6 months.

Additional restrictions on use (it is recommended to use only under the constant supervision of qualified medical workers and regular diagnostic examinations):

• recent traumatic brain injuryhistory;
• chronic;
• shock conditions;
• supraventricular ;
• benign ;
• lack of functionality of the adrenal glands.

Side effects

• From the side of cardio-vascular system and blood: atrioventricular block , ventricular tachycardia , decrease .
• From the side gastrointestinal tract: nausea , constipation (), bloating , violation of the passage through the digestive tube, increased activity of hepatic transaminases.
• Others: , , eosinophilia .

Instructions for use of Papaverine (Way and dosage)

Papaverine tablets, instructions for use

In tablets, a pharmaceutical preparation can be prescribed for both adults and children, even the frequency of administration does not change and is 3-4 times a day. The dosage of the oral form of the drug depends on the age category of the patient, the following treatment regimen is used:

• from 6 months to 2 years - 0.005 g per appointment;
• 3-4 years - 0.005-0.01 g;
• 5-6 years old - 0.01 g;
• 7-9 years old - 0.01-0.015 g;
• 10-14 years old - 0.015-0.02 g;
• adults - 0.04-0.08 g per reception.

Suppositories Papaverin, instructions for use

Is an extremely unpleasant proctological disease that is associated with , inflammatory processes and pathological expansion of hemorrhoidal veins encircling the lumen of the rectal outlet. This nosological unit is characterized by typical clinical picture , which includes impaired bowel movements, itching, bleeding from the anus. Suppositories with Papaverine will help alleviate the course of the disease.

The active ingredients of the pharmaceutical preparation allow you to relax intestinal smooth muscle elements , which facilitates the process of bowel movement, because the lumen of the rectum increases slightly. For the same reason, bleeding is stopped, since solid feces do not injure inflamed hemorrhoids, therefore suppositories with Papaverine for hemorrhoids are a kind of "magic wand".

In pharmacy kiosks, you can find suppositories with different dosages of the biologically active substance. The course of conservative sanitation should be started from 0.02 g, gradually increasing it to 0.04 g, if a smaller amount of the pharmaceutical preparation does not exert its therapeutic effect. It is not recommended to use more than 3 suppositories per day, this is fraught with the development of adverse side effects and even an overdose state, since all incoming drugs are extremely well absorbed in the rectal region.

How to use papaverine hydrochloride injection solution?

The active component of the pharmaceutical preparation has a high bioavailability, therefore, injections can be made both subcutaneously and intramuscularly, and intravenously, the therapeutic potential of the drug will not be affected by this, and the final result will be just as strong. However, it should be determined that the instructions for use recommend that subcutaneous injections of papaverine hydrochloride be made not in the distal part of the forearm, but in the shoulder or in the outer surface of the thigh, since the frequency of administration can ensure the appearance of a hematoma. Intramuscular injections of Papaverine can be carried out according to the standard scheme, that is, use the upper lateral quadrant of the buttock.

Before making intravenous injections, the amount of the pharmaceutical preparation prescribed by the doctor should be diluted with 10-20 ml of isotonic solution sodium chloride ... It should also be remembered that papaverine hydrochloride should be injected very slowly so as not to cause discomfort in the patient during the injection.

Subcutaneously, as a rule, the contents of 1 ampoule (2 ml) of a 2% solution of Papaverine Hydrochloride are injected.

Dosage of the solution in ampoules for intravenous and intramuscular administration:

• adults: single - 0.1 g, daily - 0.3;
• children from 6 months to 1 year: single - 0.005 g, daily - 0.01 g;
• at the age of 2 years: single - 0.01 g, daily - 0.02 g;
• 3-4 years: single - 0.015 g, daily - 0.03 g;
• 5-6 years: single - 0.02 g, daily - 0.04 g;
• 7-9 years: single - 0.03 g, daily 0.06 g;
• 10-14 years old: single - 0.06-0.06 g, daily - 0.1-0.2 g.

Dibazol with Papaverine - how to use?

- this is antihypertensive a drug from the group of peripheral vasodilators , that is, the active ingredients of the pharmaceutical preparation have a vasodilating effect and significantly contribute to the reduction of blood pressure. Papaverine has similar therapeutic properties in relation to the vascular system, therefore the combination of these drugs is actively used by emergency medical workers to eliminate hypertensive crisis .

Dibazol is administered with Papaverine intramuscularly or intravenously, because in this way the necessary pharmacological effects of the active ingredients develop much faster than with oral or any other method of use. The relaxing effect of biologically active ingredients can be combined with physiotherapy methods, for example, a horizontal position with a lowered foot end, warm foot baths, massage lower limbs etc.

The dosage of Dibazol with Papaverine for the elimination of hypertensive crisis is 3-5 ml of 1% Dibazol solution and 2 ml (contents of 1 ampoule) of 2% solution of the second pharmaceutical preparation. Such a large number of active ingredients can not only reduce arterial pressure, but also to stop the feeling of nausea, painful sensations in the heart and some other manifestations of cardiovascular pathology.

Overdose

Possible symptoms with active ingredients of the medicinal product:

• diplopia (double vision) ;
• weakness;
• lowering blood pressure ;
• increased fatigue .

Specific pharmaceutical no, therefore it is applied detoxification therapy and symptomatic treatment ... Gastric lavage or the use of sorbents ( milk , , for example) in the first hours after taking oral forms of papaverine hydrochloride. Also, in case of drug overdose, it is important to constantly monitor and, if necessary, artificially maintain blood pressure.

Interaction

- It is an antispasmodic, vasodilating, sedative agent, that is, in terms of pharmacological abilities, it is close to Papaverine. Medicines differ only in the mechanisms of therapeutic action, therefore Platyphyllin with Papaverine are used in the combined conservative rehabilitation of spastic syndromes, hypertensive crises and other pathological conditions.

with Papaverine, like Platyphyllin, they interact well, exerting a synergistic therapeutic effect on the smooth muscle elements of the human body. This combination of pharmaceuticals is especially common in obstetric and gynecological hospitals with uterine tone, the threat of spontaneous miscarriage or overly active early labor.

In medical publications on neurological subjects there is news that the effectiveness of the use of Levodopa significantly decreases in combined conservative therapy, from which papaverine in tablets or in the form of a solution for injection against the background of drug sanitation use is contraindicated.

Simultaneous use of papaverine with anticholinergic drugs can manifest itself in the enhancement of the therapeutic effects of the latter, therefore, if necessary, their combined use should be discussed with a reduction in dosage or temporary withdrawal of pharmaceutical preparations with a qualified specialist.

Terms of sale

The pharmaceutical product has been known since time immemorial and has always been famous for the power of its therapeutic action, therefore, earlier in the pharmacy kiosks, when buying it, a prescription in Latin was required. Nowadays, the procedure for acquiring Papaverine has become much easier, however, it is the patient's responsibility to present a correctly drawn up and certified prescription by the attending physician.

Storage conditions

In a dry, protected from direct sunlight place at a temperature not exceeding 25 degrees Celsius in a tightly packed container. The pharmaceutical product belongs to list B, therefore, its storage should be carefully monitored.

Shelf life

special instructions

Papaverine hydrochloride significantly improves peripheral blood circulation, which provides an improvement in trophic processes in individual organs when used locally. This therapeutic ability determines the use of a pharmaceutical product in bodybuilding ... Practical observations of athletes show that it is most effective to use a drug to increase the specific mass of the deltoid and biceps muscles.

The goal of athletes is to localize a certain part of the muscles, from which injections are given intramuscularly. The optimal dosage is 1-2 injections per week, which are given 15-20 minutes before an intense workout. Further, at the very beginning physical exercise, all efforts should be aimed at the "enriched" muscle, that is, engage in the "pumping" (blood pumping) system, since the therapeutic effect of Papaverine when used topically is short-lived.

The inventiveness and resourcefulness of the female half of humanity does not lag behind the stronger sex, because Papaverine hydrochloride is used even in cosmetic procedures and home care behind the skin. Due to the increased blood circulation of the peripheral parts of the body under the action of a pharmaceutical preparation, the excretion of accumulated fluid is improved, puffiness is relieved and metabolic processes are to some extent stimulated. Such therapeutic effects make it possible to use the drug to combat cellulite , elimination of the unpleasant "orange peel" in the area of \u200b\u200bthe buttocks and the back of the thigh, and even getting rid of a couple of extra pounds.

To obtain such a result, leading cosmetologists recommend using caffeine and papaverine wrap , which can be carried out even at home. To prepare the miraculous mixture, you will need 2 ampoules of caffeine benzoate, 2 ml each, 2 ampoules of Papaverine hydrochloride, 2 ml each, and a small amount of unsweetened honey. Before applying the cosmetic, the skin should be prepared, for which a light peeling, scrub or small local massage is used.

The mixture should be applied evenly over the entire area of \u200b\u200bthe treated surface with a small layer. The cosmetic product will not be absorbed right away, therefore it is necessary to tightly cover the skin with plastic wrap (cling film is ideal for this purpose) and warm up by wrapping yourself in a cotton blanket or using winter clothes. It is recommended to wrap for at least an hour, after which rinse off the remaining mixture with warm water and apply a moisturizing or nourishing cream. The duration of the course is twelve procedures, and the frequency of their conduct is every other day.

The active components of the pharmaceutical product spread their beneficial effects not only on humans, but also on animals, therefore Papaverine has found wide application in veterinary practice ... Especially often, the drug is used for cats, since pets are admitted to hospitals due to spasms of intestinal smooth muscles. The etiological factor is the hygienic procedures of the feline, because in the process of "washing", as a rule, a certain amount of wool is swallowed. Papaverine facilitates the passage of the contents of the digestive tube.

Analogs

Matching ATX level 4:

Papaverine's analogs are various pharmaceutical forms of the drug, in which it is found on pharmacy shelves. As a rule, one of the forms does not suit the patient and then another should be chosen. You can also replace these products, but you should first consult with a qualified specialist in this area, because the basic principle of medicine “do no harm” can be easily violated by ignorance.

A pharmaceutical preparation with an international non-proprietary name has a similar antispasmodic effect , which is known to a wide audience by the name. It can also be used for pregnant women, and for patients of a proctological or urological hospital, and for children in pediatric practice, and for the treatment of headaches at home.

For children

Papaverine hydrochloride is actively used in pediatric practice, starting from the age of 6 months.

Papaverine during pregnancy and lactation

What are Papaverine suppositories for during pregnancy?

The uterus, an organ of the female reproductive system, in which the intrauterine phase of fetal development directly takes place, includes both striated muscles and smooth muscles. In the process of carrying a child, an increased tone of this organ often develops, as a result of which spastic pains are possible, early contractions , premature rupture of amniotic fluid and the birth is not on the planned date. Papaverine hydrochloride has a relaxing effect, which allows you to remove the above manifestations of uterine hypertonicity.

Of course, before using the drug, you should decide on the pharmaceutical form that will have the maximum beneficial effects and will not harm the developing body of the child and mother. For pregnant women, the advisability of using one form or another of Papaverine is determined duration of gestation , for example, in the early stages it is recommended to use oral tablets, and in the later stages, intramuscular and subcutaneous administration of injection solutions manifests itself much better.

Suppositories with Papaverine during pregnancy

First of all, one should decide on a completely logical question for patients - where to insert Papaverine suppositories during pregnancy, because, as a rule, this pharmaceutical form of the drug is used rectally , however, the therapeutic effect is required not in the final sections of the gastrointestinal tract, but in the muscular elements of the genitourinary system. This misconception is characteristic of women who are completely unfamiliar with the principle of work of local pharmaceutical suppositories.

After the introduction of Papaverine, the active components of the suppositories are actively absorbed and spread first. local blood flow on nearby organs, due to which the smooth muscle elements of the uterus are supplied with biologically active substances in full. Another positive aspect of using this pharmaceutical form is the high bioavailability of rectal suppositories, that is, a large percentage of the drug enters the microvasculature, and is not excreted from out.

Injections during pregnancy

Of course the most effective way the use of papaverine hydrochloride is its intramuscular or even intravenous administration, because in this way bioavailability the drug tends to the maximum, and the concentration of the active substance remains at the highest point for the longest period of time.
It should be emphasized that the injectable form of the pharmaceutical preparation is especially relevant in late pregnancy, when uterine hypertonicity or spastic, cramping pains can lead to premature onset of labor and the discharge of amniotic fluid. If there are appropriate indications from the attending physician, it is worth thinking about inpatient treatment, because in this case the pregnant woman will be under the constant supervision of medical personnel, which cannot but inspire confidence.

The dosage of the solution for injection, as well as the frequency of use of the pharmaceutical preparation, is selected individually, as a rule, it ranges from 1 to 10 ml of 2% drug 2-4 times a day. In case of adverse consequences of conservative sanitation, you should immediately contact a qualified specialist.

Papaverine Hydrochloride tablets, instructions for pregnancy

Since the injection of a pharmaceutical preparation requires special medical knowledge and skills, and rectal suppositories can cause certain inconveniences and unpleasant sensations during their use, these pharmaceutical forms of Papaverine are often replaced with tablets that are prescribed orally. Of course, the effectiveness of such conservative therapy is somewhat lower than that of other ways of introducing an active ingredient into the body, however, from the side of everyday use, tablets have no equal.

Papaverine hydrochloride in oral form is used exclusively according to indications, and the criterion for its use is the subjective well-being of the pregnant woman, therefore there is no strict dosage of the pharmaceutical preparation. Specialists in obstetric and gynecological affairs do not recommend taking more than 4 tablets per day, which should be used 2 hours before meals in order to increase the pharmacokinetic abilities of the active ingredient.

Papaverine hydrochloride Papaverine hydrochloride

Active substance

›› Papaverine

Latin name

Papaverini hydrochloridum

Pharmacological groups: Vasodilators
›› Myotropic antispasmodics

Composition and form of release

Substance for the preparation of dosage forms; in double-layer bags of 7 kg.

Characteristic

Flavourless white crystalline powder. Let's dissolve in chloroform, we will moderately dissolve in water, we will slightly dissolve in alcohol 95%, practically insoluble in ether.

pharmachologic effect

pharmachologic effect - antispasmodic, hypotensive... Inhibits phosphodiesterase, promotes intracellular accumulation of cAMP. Lowers tone and reduces smooth muscle contractile activity.

Shelf life

Storage conditions

List B. In a dry, dark place at a temperature not exceeding 25 ° C.

. 2005 .

See what "Papaverine hydrochloride" is in other dictionaries:

PAPAVERIN HYDROCHLORIDE - Papaverini hydrochloridum. Properties. White crystalline powder slightly bitter in taste. It dissolves slowly in water (1:40), poorly in alcohol. Aqueous solutions (pH 3.0 4.5) are sterilized at 100 ° C for 30 minutes. Release form. They release ... Domestic veterinary drugs

Active ingredient ›› Papaverine (Papaverine) Latin name Papaverine ATX: ›› A03AD01 Papaverine Pharmacological groups: Vasodilators ›› Myotropic antispasmodics Composition and release form Suppositories for rectal administration1 ... ... Dictionary of Medicines

PAPAVERIN (Raraverinum). An alkaloid found in opium. Currently, they are synthesized. It is produced in the form of papaverine hydrochloride (Paraverini hуdro chloridum). In terms of chemical structure, it is 6.7 dimethoxy 1 hydrochloride (3.4 ... Dictionary of Medicines

GASTRITIS - honey. Gastritis is a lesion of the gastric mucosa with a pronounced inflammatory reaction in the case of an acute course or with morphofunctional changes in the case of a chronic course. Frequency 248.0 (registered patients with a diagnosis ... ... Handbook of diseases

PANCREATITIS ACUTE - honey. Acute pancreatitis is an inflammatory necrotic lesion of the pancreas caused by enzymatic autolysis caused by various reasons. Etiology Diseases of the biliary tract (cholelithiasis, choledocholithiasis, stenosis ... ... Handbook of diseases

Jaundice, mechanical - honey. Obstructive jaundice is a pathological syndrome caused by a violation of the outflow of bile from the bile ducts. Frequency. Most common reasons cholelithiasis (29.2% of cases), malignant tumors (67.3% of cases). In the group of patients up to 30 ... ... Handbook of diseases

Chronic recurrent disease, the main symptom of which is the formation of a defect (ulcer) in the wall of the stomach or duodenum. In the foreign literature, the terms “ulcer ... ... Medical encyclopedia

- (analgetica; Greek negative prefix a + algos pain) drugs that selectively weaken or eliminate pain. In therapeutic doses And. Page. oppress only pain sensitivity and do not disturb consciousness. Traditionally they distinguish ... Medical encyclopedia

Active ingredient ›› Bendazole * + Metamizole sodium * + Papaverine + Phenobarbital * (Bendazol * + Metamizole sodium * + Papaverine + Phenobarbital *) Latin name Andipalum ATX: ›› N02BB72 Metamizole sodium in combination with psychotropic ... ... Dictionary of Medicines

Active ingredient ›› Codeine + Morphine + Narcotine + Papaverine hydrochloride + Tebaine (Codeine + Morphine + Narcotine + Papaverine + Tebaine) Latin name Solutio Omnoponi pro injectionibus ATX: ›› N02AX Other opioids Pharmacological ... ... Dictionary of Medicines

thank

The site provides background information for information only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!

Papaverine (Latin - papaverine) is a widespread drug that has antispasmodic, vasodilatory and hypotensive effects. By origin and chemical structure, papaverine is alkaloid opium poppy, that is, it is obtained from poppy straw, but is not a narcotic substance.

Varieties, names, release forms and composition of Papaverine preparations

Papaverine is both the trade name of some drugs and the international name (INN) of the active ingredient in many drugs. Preparations with the trade name "Papaverine" are one and the same with the active substance "papaverine". This substance is called either simply papaverine, or papaverine hydrochloride... Moreover, papaverine hydrochloride is the chemical name for papaverine, and from the point of view of a doctor or patient, there is no difference between these terms.

Currently in countries the former USSR drugs that contain only papaverine as an active ingredient are usually referred to simply as "papaverine". In some cases, letters or abbreviations may be added to the word Papaverine, encoding the name of the manufacturer of the drug, for example, "Papaverine MS", "Papaverine Bufus", etc. However, in all cases we are talking about the same drug produced by different factories , but containing the active component papaverine.

In addition, there are multicomponent drugs with other names that simultaneously contain several active substances, among which there is papaverine. These are such drugs as Papazol, Andipal, Theodibaverin, etc. However, in this article we will consider exclusively monocomponent preparations containing only papaverine as an active substance and having the same name, respectively. In order to distinguish and not confuse the active substance and the name of the drug, we will write the first with a small letter, and the second with a capital letter.

Monocomponent preparations containing only papaverine as an active substance are currently produced under the following commercial names:

• Papaverine;
• Papaverine Bufus;
• Papaverine MS;
• Papaverine hydrochloride.

All four drugs are synonymous and are available in three dosage forms - oral tablets, rectal suppositories and injection. Suppositories are often referred to as "Papaverine suppositories" and the solution is often called "Papaverine shots", "Papaverine ampoules" or "Papaverine injections".

Accordingly, the composition of three dosage forms contains papaverine hydrochloride as an active substance in the following dosages:

• Tablets for adults - 40 mg;
• Tablets for children - 10 mg;
• Solution for injection - 20 mg per 1 ml;
• Rectal suppositories - 20 mg per suppository.

The composition of the auxiliary components for the same dosage form, for example, tablets, may vary depending on the manufacturer, so you should always carefully read it in the enclosed leaflet with instructions for use.

Since the pharmacological action of papaverine is multidirectional, it is simultaneously attributed to two groups of drugs, such as vasodilators (vasodilators) and antispasmodics... Accordingly, as an antispasmodic, Papaverine is used to treat functional disorders of the gastrointestinal tract, and as a vasodilator - in the treatment of erectile dysfunction.

Therapeutic effects of papaverine

Papaverine, by blocking the work of a number of enzymes, reduces tone and relaxes the smooth muscles of all internal organs. The fact is that the internal organs (stomach, intestines, blood and lymphatic vessels, bronchi, lungs, urethra, etc.) are equipped with exceptionally smooth muscles, due to the work of which their overall tone increases or decreases. With an increase in tone, the organ contracts, that is, its spasm occurs, and when it decreases, on the contrary, relaxation and expansion of the existing lumen occurs.

For example, with an increase in the tone of the smooth muscles of the intestines, bronchi or gallbladder, the organs are strongly compressed, characteristic spastic pains appear and the movement of the contents along their lumens is disturbed. That is, in the intestine, the movement of the food lump is delayed, bile stops flowing from the gallbladder, and the required amount of air cannot pass through the bronchi. In addition, any spasm of internal organs is accompanied by pain syndrome of varying intensity. Papaverine relieves spasm, relaxes organs, thereby restoring their function and relieving pain. Since the drug is not selective, it effectively relieves spasms and pains of any internal organ, and therefore is widely used. Basically, Papaverine has the same properties and therapeutic effects as the more widely known No-Shpa.

Papaverine has a relaxing effect only on internal organs, since it affects smooth muscles and does not affect striated muscles. The fact is that on the human body and in the heart there are only striated muscles, which have different properties and react to completely different stimuli and substances. Therefore, antispasmodics acting on smooth muscles do not affect the contractility of skeletal and cardiac muscles. Thus, Papaverine is able to relieve spasms and relax the muscles of internal organs without affecting the myocardium and body muscles.

Summarizing the described effects, the following main therapeutic effects of Papaverine can be distinguished:

• Relaxes smooth muscles and relieves spasms of smooth muscles of blood vessels, organs of the digestive, respiratory and genitourinary systems;
• By relaxing the muscles of the blood vessels and their subsequent expansion, it reduces blood pressure;
• High doses reduce the excitability of the heart muscle and slow down the conduction of the impulse through the heart;
• In high dosages, it has a sedative effect on the central nervous system.

Thus, Papaverine has two main pharmacological effects - antispasmodic (relieves spasm and relaxes smooth muscles) and hypotensive (lowers blood pressure).

Papaverine is rapidly absorbed into the bloodstream by any route of administration (tablets, rectal suppositories, intramuscular injections) and excreted by the kidneys. Half of the administered dose of the drug is excreted after 0.5 - 2 hours.

Papaverine (tablets and injections) - indications for use

The indications for the use of pills, injections and rectal suppositories of Papaverine are completely the same, since, regardless of the dosage form, the drug is absorbed into the blood and has systemic therapeutic effects.

Papaverine tablets, injections and suppositories are indicated for use in the following diseases and conditions:

• Spasms of smooth muscle elements of the gastrointestinal tract with various diseases, such as pylorospasm, colitis, cholecystitis, cholangitis, etc .;
• Cramping pain (for example, with colitis, flatulence, menstruation, irritable bowel syndrome (IBS), constipation, etc.);
• As part of the complex therapy of cholecystitis and renal colic as an analgesic and relieving organ spasm;
• Spasms and pains in the organs of the genitourinary system (cystitis, pyelitis, kidney stones or in the urethra, etc.);
• Bronchospasm;
• Spasm of cerebral vessels;
• Spasm of peripheral vessels, for example, with endarteritis and other diseases;
• As part of the complex therapy of angina pectoris;
• As an adjuvant in pre-anesthetic preparation (premedication).

Papaverine (papaverine hydrochloride) - instructions for use

Consider the rules and nuances of the use of each dosage form of Papaverine (tablets, suppositories and injection solution) separately.

Papaverine tablets - instructions for use

The tablets should be taken orally, swallowed whole, without chewing, biting or crushing in other ways, but with a sufficient amount of water (about 200 ml). Papaverine can be taken regardless of food, and as needed, that is, when spastic pains or painful spasms occur. However, if there are spastic pains in the organs of the gastrointestinal tract, then it is better to take Papaverine 15 to 30 minutes before meals, so that the drug stops the symptoms, and the person can eat and drink calmly.

For spasms and spastic pains of internal organs, adults and adolescents over 15 years of age are recommended to take Papaverine 40-60 mg (1-1.5 tablets) 3-4 times a day. Children should be given tablets with a special pediatric dosage of 10 mg. Moreover, the dosage of Papaverine for children is determined by age:

• 6 - 24 months - 5 mg (1/2 baby tablet) 3 - 4 times a day;
• 2 - 4 years - 5 - 10 mg (1/2 - 1 children's tablet) 3 - 4 times a day;
• 5 - 6 years old - 10 mg (1 tablet for children) 3 - 4 times a day;
• 7 - years old - 10 - 15 mg (1 - 1.5 children's tablets) 3 - 4 times a day;
• 10 - 14 years old - 15 - 20 mg (1.5 - 2 children's tablets) 3 - 4 times a day.

The duration of therapy depends on the rate of disappearance of spastic pain or relief of organ spasm. In acute conditions, papaverine is usually taken within 2 to 5 days, and in chronic conditions, 1 to 3 weeks.

Papaverine in ampoules - instructions for the production of injections

The ampoules contain a sterile 2% solution of Papaverine, ready for administration, containing 20 mg of active substance in 1 ml. Since the ampoule contains 2 ml of solution, the total dosage of Papaverine in a whole ampoule is 40 mg, which is equivalent to one adult tablet. The solution can be administered intact subcutaneously or intramuscularly, and after dilution, intravenously.

For adults and adolescents over 10 years old, the solution is administered 2 to 4 times a day, and for children under 10 years old - 2 times a day. A single dosage of Papaverine is determined by age:

• 6 - 24 months - 0.25 ml of solution 2 - 4 times a day;
• 2 - 4 years - 0.25 - 0.5 ml of solution;
• 5 - 6 years - 0.5 ml of solution;
• 7 - years old - 0.5 - 0.75 ml of solution;
• 10 - 14 years old - 0.75 - 1 ml of solution;
• 15 years and older - 1 - 2 ml of solution.

That is, in the indicated dosages, the solution is administered 2 times a day to children under 10 years old, and 2 to 4 times a day to adolescents over 10 years old and adults.

For subcutaneous or intramuscular administration, the injection site is selected first. It is optimal to inject the solution intramuscularly into the upper lateral outer surface of the thigh or the outer upper part of the shoulder, and subcutaneously into the area around the navel. Before the injection, the skin is wiped with an antiseptic, after which the required amount of solution is drawn into the syringe and injected into the prepared place. For intramuscular injection, the needle is inserted deep into the tissue perpendicular to the skin surface. And for a subcutaneous injection, first, approximately 1 cm of skin is grasped with the thumb and forefinger, making a fold out of it. After that, the needle of the syringe is set at approximately 45 ° to the skin surface and inserted into this fold. The solution is released into the tissue and the needle is carefully removed, after which the injection site is again wiped with an antiseptic. Each time, the solution should be injected at a point that is at least 1 cm away from other marks from past injections.

For intravenous administration, you must first dilute the required amount of Papaverine in 10 - 20 ml of saline. Then this mixture is administered intravenously, slowly. Intravenous injections should be made only in a hospital setting, and subcutaneous or intramuscular injections can be done at home on their own, if the person has mastered their technique and does not feel fear.

Papaverine - instructions for the use of suppositories

Suppositories are inserted into the rectum, gently pushing with the index finger through the anus. Candles should be inserted with clean hands that have just been washed with soap or with sterile gloves. The dosage of suppositories for various diseases accompanied by spasms and spastic pains is determined by age and is 1 - 2 suppositories 2 - 3 times a day for adults, and 1 suppository 2 times a day for children over 10 years old. For children under 10 years old, the candles are cut into 2 or 4 equal parts and injected with these pieces containing the required amount of the active substance. So, children under 4 years old are injected with a quarter or half of a candle, and from 5 to 10 years old - half a suppository 2 times a day.

Dosage for various diseases

The dosage of Papaverine in all dosage forms is the same for various diseases and conditions, but differs only depending on the age of the person using the drug. So, single dosages of solution, suppositories and papaverine tablets for people of different ages are as follows:

• 6 - 24 months - 5 mg each;
• 2 - 4 years - 5 - 10 mg each;
• 5 - 6 years - 10 mg each;
• 7 - years - 10 - 15 mg each;
• 10 - 14 years old - 15 - 20 mg each;
• Over 14 years old - 20 - 60 mg.

At the same time, Papaverine in the indicated dosages is taken a different number of times a day, depending on the dosage form - tablets 3 - 4 times, the solution is administered 2 - 4 times a day, and suppositories - 2 - 3 times. Moreover, children under 6 years of age should use Papaverine the smallest of the permissible amounts once a day, and at the age of 6 years, the frequency of taking the drug is determined by the person's condition, and may be maximum.

The maximum permissible single dose of Papaverine is the highest dose indicated for each age, multiplied by four. That is, for an adult, the maximum permissible single dosage is 60 * 4 \u003d 240 mg, for a child from 10 to 14 years old - 20 * 4 \u003d 80 mg, etc. The maximum allowable daily dosage is three times the maximum single dose.

special instructions

For any diseases that are indications for the use of Papaverine, you can choose the dosage form that seems most convenient at the current time. For example, if it is most convenient for a person to take pills, then this particular form should be chosen.

If you need to quickly achieve a therapeutic effect, especially in the first days of an exacerbation of the disease, then injections should be used. After 2 - 3 days, if a person can swallow, injections should be replaced with tablets or rectal suppositories. It is not recommended to carry out the entire course of therapy using subcutaneous or intramuscular injections, since this entails greater risks compared to taking pills. Therefore, injections should be given only if suppositories and pills cannot be used for some reason. In general, doctors recommend following a simple rule in choosing the form of the drug - always use either suppositories or tablets, and use injections only if necessary to obtain a quick therapeutic effect, but replace them with tablets or suppositories as soon as possible.

If a person suffers from gastrointestinal spasms, then he can use Papaverine both in suppositories and in tablets, based solely on personal preference. However, it should be remembered that when using papaverine suppositories, the clinical effect occurs faster than from tablets. Therefore, if you need to get a quick effect, it is better to use candles. It is also recommended to choose suppositories if a person, for some reason, cannot swallow pills.

With spastic pains in the organs of the urinary system, Papaverine suppositories are the best option, because when they are introduced into the rectum, the active substance very quickly reaches the affected tissues and has a powerful therapeutic effect. If for some reason suppositories are impossible or difficult to enter into the rectum, then they should be replaced with tablets.

In children, it is recommended to use Papaverine in the form of suppositories or special children's tablets with a low dosage of the active substance of 10 mg. Children should not be given halves or quarters of Papaverine tablets for adults, which contain 40 mg of the active substance.

Papaverine is not a drug intended for long-term course use, therefore it is used exclusively for one-time relief of spastic pain against the background of an exacerbation of a disease or condition. This means that pills, suppositories or injections of Papaverine can be used on their own for 2 - 3 days, after which an improvement must necessarily appear, expressed in a decrease in spastic pain and discomfort in the area of \u200b\u200blocalization of the pathological process. If there is no improvement, then you should immediately consult a doctor, as this may indicate the development of severe surgical pathology, for example, appendicitis, bleeding, peritonitis, etc.

According to the doctor's prescription, Papaverine is usually used for 7-14 days or a little longer, until the complete relief of painful spastic pains. If a person has been suffering from any chronic disease for a long time, for example, cholecystitis, then he knows very well the symptoms of its exacerbation and the dynamics of improvements that occur while taking Papaverine, and therefore can independently determine the duration of taking the drug.

If a person is faced with spastic pain for the first time, then the first course of therapy should be carried out exclusively under the supervision of a doctor and independently record their own feelings, as well as positive dynamics. In the future, with an exacerbation of the disease, spasm relief will also be performed by antispasmodics, and their dynamics will not fundamentally differ from that which was recorded for the first time. And a person who remembers well the dynamics of reducing spastic pain and normalizing the condition, during periods of exacerbations in the future will be able to independently control how well and correctly the treatment is proceeding without visiting a doctor or going to the hospital. In addition, he will be able to record any distinctive manifestations of the dynamics of treatment and report them to the doctor, who, in turn, will aim to search for their cause and deal with the problem of diagnosing combined or atypical pathology.

Overdose

An overdose of papaverine is possible and manifests itself by the appearance of double vision, weakness, drowsiness and a decrease in pressure. To treat an overdose, gastric lavage is performed, after which sorbents (activated carbon, Polysorb, etc.) and milk are given to the person, and the pressure is maintained at a normal level.

Interaction with other medications

Papaverine reduces the therapeutic effect of Levodopa and Methyldopa.

In addition, No-Shpa with Papaverine is often used to prepare the cervix for childbirth, for which women take 1 tablet or inject 1 suppository of each drug 2 times a day for 2 weeks before the expected date of birth. This practice is widespread, but these preparations for preparing the cervix do more harm than good, because just before childbirth, when the uterus must actively contract and prepare, it is artificially "inhibited" by antispasmodics, relaxing muscles and reducing tone. As a result of the use of No-Shpa with Papaverine "to prepare the cervix", the likelihood of weakness in labor and, accordingly, the use of labor stimulation, labor induction and the imposition of forceps or vacuum increases. That is, it is not the preparation of the cervix that occurs, but the oppression of labor.

The use of No-Shpy with Papaverine does not reduce the risk of rupture, which in most cases depends only on the competent management of childbirth by a doctor. And to prepare the cervix for childbirth, which is carried out only when prolonged or urgent delivery is necessary against the background of a threat to the mother's life, completely different drugs are used (Prostin, etc.) and non-pharmacological agents (kelp, Foley catheter, etc.).

Papaverine for children

Papaverine in any dosage form can be used in infants from three months of age. The instructions usually indicate that the drug is approved for use from 6 months, but practicing pediatricians, based on long-term observations of the use of Papaverine, consider its use from 3 months to be justified and safe. After all, Papaverine is also part of the popular drug Omnopon, used for pain relief in labor.

In babies of the first year of life, Papaverine is used mainly to relieve spastic pain and intestinal colic, and in older children - to relieve bronchospasm, as well as in the complex therapy of pancreatitis, hepatic colic and urethral spasms. In addition, if the child has a high fever and white, cold hands and feet, then Papaverine is given in order to dilate blood vessels 15 to 20 minutes before the antipyretic drug. In a situation where the hands and feet are cold, and the temperature is very high, antipyretic without first taking an antispasmodic (Papaverine, No-Shpy, Drotaverin, etc.) will not work, since the narrowed, spasmodic vessels will not give off excessive heat and cool the body ...

Papaverine in children is used in all three dosage forms at dosages depending on age:

• 6 - 24 months - 5 mg (1/2 baby tablet, 0.25 ml of solution or 1/4 suppository) 2 times a day;
• 24 years - 5 - 10 mg (1/2 - 1 children's tablet, 0.25 - 0.5 ml of solution or 1/4 - 1/2 candles) 2 times a day;
• 5 - 6 years old - 10 mg (1 children's tablet, 0.5 ml of solution or half a candle) 2 times a day;
• 7 - 9 years old - 10 - 15 mg (1 - 1.5 children's tablets, 0.5 - 0.75 ml of solution or 1/2 - 2/3 candles) 2 - 3 times a day;
• 10 - 14 years old - 15 - 20 mg (1.5 - 2 children's tablets, 0.75 - 1 ml of solution, 2/3 - 1 candle) 2 - 3 times a day;
• Teenagers over 14 years old - 20 - 40 mg each (1 adult pill, 1 - 2 ml of solution or 1 - 2 suppositories) 3 - 4 times a day.

Children should only be given special children's papaverine tablets, which contain 10 mg of the active substance, and not broken into small parts by adults. When using a solution, small syringes should be taken in order to accurately measure the required amount of the drug. And when using candles, they must be cut into pieces along, not across. In young children, it is recommended to use Papaverine in suppositories or solution, since they still have difficulty swallowing tablets. In older age groups, any convenient dosage form can be used.

Papaverine from pressure

Papaverine dilates blood vessels and moderately lowers blood pressure, but it is not used as a specific antihypertensive drug for long-term treatment. Papaverine in combination with Dibazol is usually administered by injection for hypertensive crisis

• Hypersensitivity to drug components;
• AV block;
• Liver failure;
• Elderly age over 65;
• Children under 6 months of age.

In addition to these contraindications, there are a number of conditions in which Papaverine should not be used until recovery or complete rehabilitation. These conditions are temporary restrictions on the use of the drug, since after their cure or stabilization of the condition, Papaverine can be used with caution. So, the restrictions on the use of the solution, suppositories and tablets of Papaverine are the following conditions:

• Traumatic brain injury suffered during the last 6 months;
• Shock states;
• Chronic renal failure 1. Bioshpa tablets;
  2. Vero-Drotaverine tablets;
  3. Droverin injection, tablets;
  4. Drotaverin MS, Drotaverin forte, Drotaverin-UBF, Drotaverin-Teva and Drotaverin-FPO - tablets;
  5. Drotaverin-Ellara injection solution;
  6. Nikoverin tablets;
  7. No-Shpa tablets and injection;
  8. No-spa forte tablets;
  9. Nosh-Bra solution for injection and tablets;
  10. Papazol and Papazol-UBF tablets;
  11. Platyphylline with papaverine tablets;
  12. Ple-Spa tablets;
  13. Spazmol injection and tablets;
  14. Spazmonet and Spazmonet forte tablets;
  15. Spazoverin tablets;
  16. Spakovin injection and tablets.

  Description of the dosage form

  Papaverine
  Papaverine hydrochloride (Papaverine hydrochloride)

  Composition and form of release
  Rectal suppositories: 1 suppository contains papaverine hydrochloride 20 mg;
  excipients: solid fat, type A or witepsol - a sufficient amount to obtain a suppository weighing from 1.19 to 1.31 g;
  in a contour acheikova package 5 pcs., in a cardboard box 2 packages.

  Solution for injection 2%:
  1 mg of solution contains 20 mg of papaverine hydrochloride;
  in ampoules of 2 ml, 10 ampoules in a box.

  Pills: 1 tablet contains 40 mg of papaverine hydrochloride;
  10 tablets per pack.

  pharmachologic effect
  Myotropic antispasmodic agent. Has a hypotensive effect. Inhibits phosphodiesterase, causes the accumulation of cyclic 3`, 5`-AMP in the cell and a decrease in the calcium content; reduces tone and relaxes the smooth muscles of the internal organs (gastrointestinal tract, respiratory and genitourinary systems) and blood vessels. It causes the expansion of arteries, increases blood flow, incl. cerebral. In large doses, it reduces the excitability of the heart muscle and slows down intracardiac conduction. The effect on the central nervous system is weak, but in high doses it has a sedative effect.

  Myotropic antispasmodic agent. Reduces the tone of smooth muscles of internal organs and blood vessels. It causes the expansion of arteries, increases blood flow, incl. cerebral. When used in moderate therapeutic doses, papaverine has practically no effect on the central nervous system.
  

  Pharmacokinetics
  The absorption is high. Penetrates through histohematogenous barriers. Excreted by the kidneys (as metabolites).

  Indications
  Spasm of smooth muscles of the abdominal organs (cholecystitis, pylorospasm, spastic colitis, renal colic);
  peripheral vasospasm (endarteritis);
  cerebral vasospasm;
  angina pectoris (as part of complex therapy);
  bronchospasm.

  Contraindications
  Hypersensitivity, AV blockade, glaucoma, abnormal liver function, old age (risk of hyperthermia), childhood (up to 6 months).

  Method of administration and dosage
  Pills : inside adults 40-60 mg 3-4 times a day. Children aged 6 months. up to 2 years - 5 mg, 3-4 years - 5-10 mg, 5-6 years old -10 mg, 7-9 years old - 10-15 mg, 10-14 years old - 15-20 mg 3-4 times a day.

  Solution for injection: S / c, i / m - 1-2 ml of 2% solution (20-40 mg) 2-4 times a day; IV, slowly 20 mg with preliminary dilution in 10-20 ml of 0.9% sodium chloride solution.
  For elderly patients initial single dose - no more than 10 mg.

  Suppositories: rectally, 20-40 mg 2-3 times a day (for adults).

  Side effect
  Allergic reactions; AV block, ventricular premature beats, decreased blood pressure, constipation, drowsiness, increased activity of "hepatic" "transaminases, eosinophilia.

  Overdose
  Diplopia, weakness, drowsiness.

  special instructions
  It should be used with caution and in small doses in elderly and debilitated patients, as well as in patients with traumatic brain injury, impaired liver and kidney function, hypothyroidism, adrenal insufficiency, prostatic hypertrophy, with supraventricular tachycardia and shock.
  IV should be administered slowly and under medical supervision.
  During pregnancy and lactation, the safety and effectiveness of papaverine hydrochloride has not been established.
  During the period of treatment, alcohol consumption should be excluded.

  Drug interactions
  Reduces the effect of the add-on. When smoked, the effectiveness decreases.

  Storage conditions
  Store in a dark place.

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